Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2021; 9(8): 1835-1843
Published online Mar 16, 2021. doi: 10.12998/wjcc.v9.i8.1835
Conservative endodontic management using a calcium silicate bioceramic sealer for delayed root fracture: A case report and review of the literature
Pei Zheng, Zhen-Yu Shen, Bai-Ping Fu
Pei Zheng, Bai-Ping Fu, The Affiliated Stomatology Hospital, Zhejiang University, Hangzhou 310006, Zhejiang Province, China
Pei Zheng, Zhen-Yu Shen, School of Stomatology, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Author contributions: Zheng P was the patient’s endodontic specialist, reviewed the literature, and contributed to manuscript drafting; Shen ZY and Fu BP reviewed the literature and contributed to manuscript drafting; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bai-Ping Fu, BMed, MD, Director, Professor, The Affiliated Stomatology Hospital, Zhejiang University, No. 395 Yanan Road, Hangzhou 310006, Zhejiang Province, China. fbp@zju.edu.cn
Received: November 11, 2020
Peer-review started: November 11, 2020
First decision: December 3, 2020
Revised: December 11, 2020
Accepted: January 14, 2021
Article in press: January 14, 2021
Published online: March 16, 2021
Processing time: 113 Days and 22.2 Hours
Abstract
BACKGROUND

The success rate of conservative endodontic management for root fracture varies greatly based on different methods used. It has been rarely reported that calcium silicate-based materials are applied in root fracture treatment.

CASE SUMMARY

A 38-year-old male patient presented with spontaneous pain from the upper left anterior teeth for 1 wk. The spontaneous pain was subsequently relieved, but pain on mastication persisted for 3 d. The patient had a dental trauma from a boxing match 15 years ago. Cone beam computed tomography showed that the maxillary left central incisor had oblique fracture lines and a radiolucent lesion around the fracture line. The tooth was diagnosed with an oblique root fracture with no healing and symptomatic apical periodontitis. In the following conservative endodontic management, the coronal and apical fragments of the canal both were chemo-mechanically prepared and obturated using a single cone gutta-percha with iRoot SP (Innovative BioCreamix Inc, Vancouver, Canada), a new calcium silicate-based bioceramic root canal sealer. At follow-ups at 1, 6, 12, and 24 mo, the patient was asymptomatic and the radiolucency around the fracture line was healing radiographically.

CONCLUSION

Conservative root canal treatment is an alternative treatment in some cases of oblique root fracture with no healing. The application of bioceramic sealers and single core obturation techniques may also be essential to obtain an excellent outcome.

Keywords: Oblique root fracture; Endodontic treatments; Single core obturation; iRoot SP; Calcium silicate-based sealer; Case report

Core Tip: This case report describes conservative endodontic management of a delayed oblique root fracture in a maxillary central incisor. In this delayed root fracture case, the coronal and the apical fragments of the canal were both chemo-mechanically prepared and obturated using a single cone gutta-percha with iRoot SP, a new calcium silicate based bioceramic root canal sealer. At follow-ups at 1, 6, 12, and 24 mo, the patient was asymptomatic and the radiolucency around the fracture line was healing radiographically. Conservative root canal treatment should be considered as an alternative treatment in some cases of oblique root fracture with no healing. The application of bioceramic sealers and single core obturation techniques may also be essential to obtain an excellent outcome.